Throughout history, advancements in healthcare and technology have typically been accompanied by decreasing mortality rates, with this trend only halted by exceptional factors such as wars, natural disasters or disease epidemics. However, a recent investigation by the New York Times has revealed that the death rate for young white Americans is currently increasing, and suggests that opioid overdoses could be the main cause of this alarming shift.
Opioids are synthetic or natural compounds that bind to the brain’s opiate receptors in order to block pain. A number of opioids – such as hydrocodone, oxycodone and morphine – are used to manufacture prescription painkillers, while others are found in street drugs such as heroin. According to the New York Times report, a sharp increase in overdose deaths over the past 15 years has resulted in white adults aged 25 to 34 becoming the first generation since the Vietnam War to experience higher death rates in early adulthood than the generation preceding them.
According to figures released by the Centers for Disease Control and Prevention (CDC), the number of deaths in this demographic increased by 24 percent between 2004 and 2014, despite the population of the group only increasing 5 percent. In an attempt to locate the main driver of this uptick in mortality, the New York Times analyzed almost 60 million death certificates, and found that overdose death rate increased five-fold since 1999.
A large increase in overdose deaths has been cited as the major driver of rising mortality rates among young white Americans. David Smart/Shutterstock
Although both prescription and street opioids are thought to be responsible, it is likely that increasing use of the former is largely responsible for this staggering trend. According to Caleb Alexander, co-director of the Johns Hopkins Center for Drug Safety and Effectiveness, reckless prescription practices have been commonplace in the U.S for some time, and are only now beginning to change as a result of improving awareness of the dangers of opioid painkillers.
Speaking to New Scientist, Alexander explained that “when I was in training we were routinely taught that one need not be concerned about the addiction potential of opioids,” adding that, in reality, “nothing could be further from the truth.”
Possibly as a result of this outlook, a recent study found that more than half of female patients being treated for opioid addiction at a methadone clinic reported prescription drugs as their first contact with opioid compounds.
The fact that this rise in mortality comes in an age when deaths from more common killers such as cancer are decreasing points to just how severe the situation is. Looking at the numbers involved, Jonathan Skinner of The Dartmouth Institute for Health Policy & Clinical Practice told the New York Times that they resembled what one might expect to see as a result of an infectious disease outbreak.
However, this dramatic rise in both overdoses and overall death rates in young people was found to apply only to non-Hispanic whites, with those from other backgrounds remaining unaffected by this trend. According to Andrew Kolodny, a drug expert from Brandeis University, this may be because of discrimination, with doctors being reluctant to prescribe opioid drugs to non-whites for fear that they may sell them or abuse them. Alternatively, the cause of this phenomenon may reside in the findings of a recent study that found increasing financial and social stress on white American men had been driving greater numbers to use drugs. The same paper also cited a significant rise in suicides as a major driver of spiraling death rates among this demographic.
In response to the steady increase in opioid overdose deaths in recent years, the CDC has published a set of guidelines for safe prescription practices, which it hopes will help to curb this epidemic.